SANTA ANA (CNS) - Orange County continues to show declining trends in cases of COVID-19, giving county officials hope of graduating to the less-restrictive red tier of the state's coronavirus reopening system by St. Patrick's Day.
The county on Wednesday reported 160 new COVID-19 cases, hiking the cumulative total to 246,980, and 14 more fatalities, raising the death toll to 3,966.
Hospitalization rates continued to decline, with 403 patients as of Wednesday, down from 425 on Tuesday, with 107 in intensive care, a drop from 116 on Tuesday.
The county has 30.8% of its intensive care unit beds and 65% of its ventilators available.
The county reported 9,713 tests, raising the cumulative total to 3,064,819.
Outbreaks -- defined as two or more confirmed cases within the past two weeks -- have declined significantly in the county's nursing homes, with just two skilled nursing facilities and three elderly assisted living facilities in that metric.
Fairview Developmental Center in Costa Mesa, which is set to close on March 15, has just eight patients. The facility, which was reopened on Dec. 15, was being used for recuperating coronavirus patients who no longer need to be hospitalized.
The outbreak in the county's jails was also down to six infections, with three involving newly booked inmates. None of the inmates are hospitalized, and officials are awaiting results of 549 tests.
The fatalities logged on Wednesday -- death reports can lag for weeks - - increased the death toll for January to 1,254, 884 for December and 124 in February. January was the deadliest month since the start of the pandemic.
“I'm pretty optimistic that two weeks from now we'll be able to enter the red tier,'' Dr. Clayton Chau, the county's chief health officer and director of the OCHCA, said Tuesday.
If the county can maintain the case rates and positivity rates it has now, it could enter the red tier by March 17, Chau said. The county must then hold those rates for another two weeks to qualify for a less-restrictive tier that would allow for the reopening of more businesses.
Chau said vaccines are making the difference in reductions in infections across the country, and he was further cheered by news from the Biden administration that there will be enough vaccines for all American adults by the end of May.
“That's great news,'' he said. “Now, we can truly talk about the green tier'' -- when the state is free of any restrictions.
Chau was also optimistic that by the end of March, vaccines will be available to everyone who is currently eligible.
“The reason all this tiering is happening now is because we have a very limited amount of vaccine and we want to target those most vulnerable,'' Chau said, referring to the various phases of vaccine availability that started with health care workers and first responders and now includes seniors 65 and older, food industry workers and educators.
Meanwhile, in a major policy shift, state officials on Wednesday night said they will now devote 40% of available vaccines to people in disadvantaged areas, according to a published report. The Los Angeles Times said that, after 400,000 doses are administered to people in the state's hardest-hit areas, the state also plans to significantly relax rules for counties to exit the most restrictive tier of the state's four-level reopening blueprint. The change comes amid continuing evidence that Black and Latino communities are lagging in gaining access to vaccinations.
Chau implored residents to get vaccinated when they can, no matter which particular vaccine is offered.
“All three vaccines offer 100% effectiveness'' in preventing severe illness that leads to hospitalization, Chau said of the Moderna, Pfizer and Johnson & Johnson vaccines.
Even though the Johnson & Johnson vaccine may not be as effective at preventing any infection as Moderna and Pfizer, it will still be attractive to many because it does not require a booster shot, Chau said.
The numbers governing the state's tiered network for reopening the economy are updated every Tuesday, with purple being the most restrictive, red the next one up and then orange and the least-restrictive yellow. But those reports reflect numbers through Sunday, and as of Sunday, Orange County did not meet the criteria for the red tier.
The county's test positivity rate improved to 3.9% from 5.4% last week, and the adjusted case rate per 100,000 on a seven-day average with a seven-day lag improved from 11.9 to 7.6.
The Health Equity Quartile Positivity Rate, which reflects the rates in hot spots in disadvantaged neighborhoods, improved from 7% to 5%. That puts the positivity rates in orange and the case rate in purple.
The county's most recent overall testing positivity rate was at 3.8% and the health-equity positivity rate was at 4.9%, which would put both in the orange tier, said Orange County CEO Frank Kim. The case rate per 100,000 residents, however, was at 7.6, just short of the red tier.
The state has an exception that allows a county to move up to the next tier if two metrics are in an advanced tier and one is lagging behind. For instance, if the case rate per 100,000 remained in the purple tier, but the positivity rates were orange, the county could theoretically move up to the red tier if it can maintain those levels for two consecutive weeks, Kim said.
“You've got to make it and then hold it for two weeks and one day and then you can reopen,'' he said.
There's no guarantee of that, though, Kim said.
“The case rate plateaued,'' he said. “It was flat the last two days... I thought we'd be closer to the red tier, but we're not. We didn't make any progress over the last day, but I still think we'll make it by next Sunday, but I can't assure anyone of that.''
To get to the red tier, the county has to have a case rate per 100,000 population of 4 to 7, a positivity rate of 5% to 8% and a Health Equity Quartile rate of 5.3% to 8%.
The red tier allows for many more businesses and organizations to reopen. For instance, retail stores could allow for half capacity instead of 25%, and museums, zoos and aquariums could reopen for indoor activities at 25% capacity, as could movie theaters, gyms and restaurants.
Public health professionals are “worried there could be a second surge'' if residents drop their guard as news flows in about vaccines, including the newly authorized Johnson & Johnson vaccine, Kim said.
“They're concerned people will stop listening to the health professionals and we'll potentially have another surge, and every time we have a surge it takes at least two months to turn it around properly. It's painful.''
Orange County officials have not yet received word on when Johnson & Johnson vaccines will arrive.
County officials will close down the Disneyland mass vaccine distribution site for a few days starting Thursday, so the tents there can be reconfigured to allow for drive-thru access for the disabled, Kim said.
The Santa Ana College vaccine site reopened Wednesday, more than a week after it was shut down due to a shortfall in vaccine supply stemming from weather-related delays in deliveries from back east.
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